Costs, effects and implementation of routine data emergency admission risk prediction models in primary care for patients with, or at risk of, chronic conditions: a systematic review protocol

INTRODUCTION: Emergency admission risk prediction models are increasingly used to identify patients, typically with one or more chronic conditions, for proactive management in primary care to avoid admissions, save costs and improve patient experience. AIM: To identify and review the published evidence on the costs, effects and implementation of emergency admission risk prediction models in primary care for patients with, or at risk of, chronic conditions. METHODS: We shall search for studies of healthcare interventions using routine data-generated emergency admission risk models. We shall report: the effects on emergency admissions and health costs; clinician and patient views; and implementation findings. We shall search ASSIA, CINAHL, the Cochrane Library, HMIC, ISI Web of Science, MEDLINE and Scopus from 2005, review references in and citations of included articles, search key journals and contact experts. Study selection, data extraction and quality assessment will be performed by two independent reviewers. ETHICS AND DISSEMINATION: No ethical permissions are required for this study using published data. Findings will be disseminated widely, including publication in a peer-reviewed journal and through conferences in primary and emergency care and chronic conditions. We judge our results will help a wide audience including primary care practitioners and commissioners, and policymakers. TRIAL REGISTRATION NUMBER: CRD42015016874; Pre-results

Healthy Aging in Relation to Chronic Pain and Quality of Life in Europe

Objective: To undertake a review of the most recent data on the relationship between quality of life (QoL) and chronic pain, as a basis for discussions about healthy aging in Europe. Method: A search was conducted to obtain studies on the relationship between pain severity and QoL and intervention studies reporting both QoL and pain severity in those with chronic pain in Europe. Medline and Embase were searched for observational studies and systematic reviews from 2009 to 2011. Four further databases were searched for systematic reviews and guidance from 2005 to 2011. Update searches for observational studies and systematic reviews for the period November 2011 to January 2013 were performed on Medline and Embase. Results: We identified 8 observational studies and 1 systematic review that generally showed a statistically significant relationship between pain severity and QoL. We identified 5 systematic reviews of interventions in chronic pain that summarized both pain and QoL data that generally showed both a statistically significant reduction in pain and statistically significant increase in QoL. Conclusion: There is strong evidence of a correlation between pain severity and QoL. There is some evidence that treatment in chronic pain patients can reduce pain and simultaneously improve QoL. Prevention and treatment of chronic pain may be of significant help in reaching the aim to increase the healthy lifespan